Discussions By Condition: Heart conditions

Stress Tests

I recently had a cardiac stress test. The treadmill portion indicated an issue with "depression in the inferior leads which may indicate ischemia". However, the nuclear imaging portion was completely negative. The cardiologist apparently dismissed the treadmill poriton, saying that they relied more on the nuclear part.

I have read that the treadmill test will not indicate a problem unless there is at least a 50% narrowing/blockage. Otherwise, it will go undetected. Given that fact, I am concerned that the cardioiologist may have dismissed this portion of the test too easily. I would rather have further testing to "break the tie", or better yet repeat the stress test.

2 Replies:

Hey Larry Stress test are notorious for being wrong. The "depression in the inferior leads which may indicate ischemia" is referring to the EKG portion of the test. Have another EKG if you are worried. What caused your cardiologist to give you this test? If it is chest pain, and you continue to have it, you must persist in finding the cause. Most cardiologist will continue to investigate, after negative results on the stress test, if the patient's chest pain continues. Normally (or in the past) the next step in detecting coronary artery blockages would be the cardiac cath, but now there is a new non-invasive test called the "64 Slice Coronary Artery CT scan" that is almost as good as the gold standard in finding blockages, the "cardiac catheterization". There is a significant amount of radiation involved with this CT scan. That is the only drawback, and is a nasty little secret. I had one and it was 100% correct as verified by a follow up cath. Good Luck

Thanks for getting back. It was a heartburn-like burning (not pain) following eating which occurred two days in a row (2 weeks ago). It has since passed. I was able to get a copy of my treadmill test and noted that each of 3 inferior leads did decrease in value by exactly 0.40 mm during the final 1 minute of the test (minute 9). This apparently created the issue. I also noted that several other leads decreased in value during that final minute, but not by as much. Almost as if an alarm goes off if a certain "differential" is hit. I never really wanted to be this educated on the human heart! Larry